In the last few years, several episodes of violence and shocking police brutality have brought the fragility of black lives into the light of national media coverage. But at the same time, another important—and, perhaps, equally complicated—story is emerging: African Americans, and young black men in particular, are on average living much longer than they were just two decades ago.
The decline in mortality has been especially dramatic among young African American children and teenagers. The death rate for black men between the ages of 20 and 49 dropped by half between 1990 and 2010. African Americans are the only ethnic group with a declining suicide rate since the turn of the century. The longevity gap between blacks and whites, once as large as seven years in 1990, has shrunk to three years, the smallest gap on record. These positive developments are encased in graver news: Black Americans still live shorter lives, on average, and they die at higher rates than whites from infant mortality, heart disease, and homicide, as Sabrina Tavernise reported in the New York Times. Moreover, rising mortality rates among white Americans are also in part responsible for the smaller gap.
The declining death rate of black Americans is a statistical mystery: Researchers aren’t sure which factors account for most of the decline.
One reasonable theory is that a drop in violence has been a critical factor. Murders are still the top cause of death for African Americans between 15 and 34. But the rate of homicide deaths among African Americans has decreased by a stunning 40 percent since the mid-1990s (versus a 28 percent decline for whites). As for what’s caused this decline in violence, there are as many questions and answers. A full explication is probably a mosaic of cultural and policy changes, including the phase-out of leaded gasoline by the Clean Air Act and changes in police tactics.
But the declining death rate for black Americans might also be the outcome of deliberate economic and health care policies. In April, two economists, Janet Currie and Hannes Schwandt, published an analysis of life expectancy in rich and poor neighborhoods since 1990. They discovered surprisingly good news. Among infants, children, and young adults, mortality is falling faster in poor areas. This was, they concluded, largely a story of declining black mortality. "The reductions in mortality among African Americans, especially African American males of all ages, are stunning," they wrote. The authors aren’t sure what has caused the decline in mortality rates for black children, but their explanations include “the expansion of public health insurance” and “expansions of the Earned Income Tax Credit,” which pays thousands of dollars to poor working parents with children.
The most significant decline in mortality rates happened among black children under five between 1990 and 2000. This coincides with a dramatic expansion of Medicaid. The government insurance program for low-income families hardly grew between the 1970s and 1980s. But in the early 1990s, enrollment expanded by more than 10 million people, according to Medicaid Financial Management Reports.
In 1993, the Centers for Disease Control and Prevention published a report that found that between 1960 and 1988, infant mortality in the U.S. declined by about 60 percent, with black postneonatal mortality declining faster than the rest of the country. It is plausible that more equal access to medical care, particularly for babies and young children, is a major factor in rising longevity among African Americans. It has been surprisingly difficult for economists to pin down Medicaid’s effect on longer healthier lives, but the largest and most recent studies have shown that Medicaid recipients have “better self-reported physical and mental health.”
According to the CDC, the most important reasons why black Americans are closing the life-expectancy gap with whites is “reductions in the number of people dying of heart disease, cancer, and HIV.” This suggests that national behavior changes, such as declining rates of HIV infection and smoking, are having the most significant effect. In particular, smoking rates have declined more among blacks than whites, and black women, who were more likely to smoke than white women in 1985, are now less likely to be cigarette smokers.
It’s easier for most journalists to tell the story of breaking news events than quiet gradual social changes, and the declining death rate of black Americans has occurred outside of the limelight of most national coverage. It remains a remarkable development seeking a compelling explanation. For now, a reasonable theory is that, in addition to the overall decline in violent crime, African Americans are benefiting from both national behavioral changes, like less smoking, and from the expansion of government spending to help the poor and pay for food, education, and, most importantly, health care.